Organization
CENTRAL TEXAS RADIOLOGICAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN SORENSEN MD (PARTNER)
(254) 751-4299
Entity
Organization
Contact information
Practice address
6901 MEDICAL PKWY, RADIOLOGY DEPARTMENT, WACO, TX 76712-7910
(254) 751-4299
(903) 663-7394
Mailing address
3206 4TH ST, LONGVIEW, TX 75605-5143
(903) 663-4800
(903) 663-7394
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023AK
BLUE CROSS AND BLUE SHIELD OF TEXAS
TX
05
—
080211802
—
TX
01
—
CD0257
RAILROAD MEDICARE
TX
Enumeration date
03/24/2006
Last updated
03/06/2017
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